title: Mortality in patients with IgA nephropathy.
abstract: BACKGROUND
  Immunoglobulin A nephropathy (IgAN) is the most common glomerulonephritis globally. Few studies have investigated mortality in patients with IgAN compared with the age- and sex-adjusted general population.
  
  
  METHODS
  Cohort study with record linkage between the Norwegian Kidney Biopsy Registry, Norwegian Cause of Death Registry, and Norwegian Renal Registry.
  
  
  METHODS
  633 patients diagnosed with IgAN in 1988-2004.
  
  
  METHODS
  Estimated glomerular filtration rate (eGFR), age, and sex.
  
  
  RESULTS
  Deaths and causes of death before and after the onset of end-stage renal disease through 2008.
  
  
  RESULTS
  Mean follow-up was 11.8 (range, 0-20.8) years. During the observation period, the observed number of deaths was 80 and the expected number was 42.1, resulting in a standardized mortality ratio (SMR) of 1.9 (95% CI, 1.5-2.4). Risk stratification based on initial eGFR showed that SMR was 1.0 (95% CI, 0.6-1.6) if eGFR was ≥60 mL/min/1.73 m(2), 1.9 (95% CI, 1.3-2.8) if eGFR was 30-60 mL/min/1.73 m(2), and 3.6 (95% CI, 2.6-5.0) in patients with eGFR <30 mL/min/1.73 m(2). Renal replacement therapy (RRT) was initiated in 146 patients and 35 of the 80 deaths occurred after the start of RRT. The age- and sex-adjusted SMR was not increased significantly in the pre-RRT period (1.3; 95% CI, 1.0-1.7), but was increased after initiation of RRT (4.9; 95% CI, 3.5-7.0). The most common cause of death was cardiovascular disease, accounting for 45% of all deaths.
  
  
  CONCLUSIONS
  Treatment during follow-up is not known.
  
  
  CONCLUSIONS
  Mortality in patients with IgAN was twice the expected rate, but not significantly increased before RRT. The risk of end-stage renal disease was substantially higher than risk of death.
authors.affiliation: Department of Clinical Medicine, Renal Research Group, University of Bergen, Bergen, Norway; Department of Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Knoop
authors.forename: Bjørn Egil
authors.initials: BE
authors.lastname: Vikse
authors.forename: Einar
authors.initials: E
authors.lastname: Svarstad
authors.forename: Sabine
authors.initials: S
authors.lastname: Leh
authors.forename: Anna Varberg
authors.initials: AV
authors.lastname: Reisæter
authors.forename: Rune
authors.initials: R
authors.lastname: Bjørneklett
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D005922:Glomerulonephritis, IGA / Q000453:epidemiology* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012042:Registries; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Immunoglobulin A nephropathy; end-stage renal disease; mortality; prognosis; risk factor